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Davidoff AJ, Hu X, Parsons HM, Zheng Z. Early impact of the Affordable Care Act (ACA) on financial worry. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.7_suppl.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
44 Background: We examined changes in financial worry for working-aged cancer survivors compared to individuals without a cancer history (controls) after ACA-mandated health insurance enrollment and caps on cost-sharing were implemented in 2014. We hypothesized that cancer survivors would be more likely to report financial worry, and that ACA implementation would reduce financial worry. Methods: We pooled data from the 2013-2014 National Health Interview Survey for adults aged 21-64 years. Cancer survivors were identified based on self-report of ever being told by a physician that they had cancer (excluding non-melanoma skin cancer). Reports of worry about eight financial matters were dichotomized as “very worried” vs. “less worried”; a summary measure captured reports of being “very worried” about any item. Linear probability regressions assessed the impact of being a cancer survivor and the post-ACA period on high financial worry, controlling for demographics and health status. Interaction terms between cancer and post-ACA tested for differential ACA effects for cancer survivors. Results: Compared to controls (n = 50,304), cancer survivors (n = 2,192) were more likely to report being very worried about finances pre-ACA (46.7% vs. 39.6%) and post-ACA (42.3% vs. 36.0%). The ACA was associated with an adjusted 3.9 (CI: 2.9-4.9) percentage point (PPT) decrease in the probability of financial worry overall. Being a cancer survivor was associated with increased likelihood of being very worried about finances overall (PPT = 3.5, CI: 0.8-6.2), medical costs associated with a serious illness (PPT = 3.4, CI: 0.9-5.9) and normal healthcare (PPT = 3.4, CI: 1.1-5.7), having enough money for retirement (PPT = 2.4, CI: 0.0-4.8), and being able to maintain an enjoyable standard of living (PPT = 2.5, CI: 0.3-4.7). The ACA did not affect financial worry for cancer survivors differently than for controls. Conclusions: The ACA was associated with small but significant reductions in financial worry for working-aged adults, with similar effects for cancer survivors and controls. Cancer survivors were more likely to report financial worry, and worried about both paying for healthcare and the ability to maintain an adequate financial position in the short and longer run.
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Affiliation(s)
| | - Xin Hu
- Yale University School of Medicine, New Haven, CT
| | - Helen M. Parsons
- The University of Texas Health Science Center at San Antonio, San Antonio, TX
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